Christel Diamond, APRN-FPA

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

277.000483 Issued in IL

Practice address

114 E Cook Ave
Libertyville, IL 60048-2015

Phone

(224) 504-1114

NPI assigned

Mar 2, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Christel Russo Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bonaventure Medical Foundation, LLC

  • Family Medicine Physician
  • Elk Grove Village, IL
  • NPI 1588775647
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1306086491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E COOK AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482015",
            "telephone_number": "224-504-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E COOK AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482015",
            "telephone_number": "224-504-1114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20771 N. Rand Rd",
            "address_2": "Building C3, Suite 100",
            "address_purpose": "LOCATION",
            "city": "Kildeer",
            "state": "IL",
            "postal_code": "60047",
            "country_code": "US",
            "telephone_number": "312-767-7753",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Oakbrook Ctr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Oak Brook",
            "state": "IL",
            "postal_code": "605234724",
            "country_code": "US",
            "telephone_number": "630-518-4201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 S Milwaukee Ave # 106",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600483796",
            "country_code": "US",
            "telephone_number": "312-767-7753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAMOND",
        "first_name": "CHRISTEL",
        "credential": "APRN-FPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-02",
        "last_updated": "2022-03-16",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277.000483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTEL",
            "last_name": "RUSSO",
            "credential": "APRN-FPA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Nurse Practitioner in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.